Posts tagged Chad

Photo by Samantha Maurin/MSF
Refugees pose for a photo in the Clément center in N’Djamena, the capital of Chad. Six hundred Central African refugees are living in this transit center constructed by the government of Chad in order to accommodate the 15,000 people who were evacuated from Bangui, Central African Republic (CAR), by air. Doctors Without Borders/Médecins Sans Frontières (MSF) conducts medical consultations in each of the eight sites hosting the CAR refugees in N’Djamena. MSF’s mobile teams found many patients in need of basic health care, as well as several serious post-op cases that required follow-up. There is an increasing need of water and sanitation provision, which MSF teams are supporting. MSF has also set up operations in the south of Chad, in Bitoye and Sido, where an additional 25,000 refugees have arrived from CAR.

Photo by Samantha Maurin/MSF

Refugees pose for a photo in the Clément center in N’Djamena, the capital of Chad. Six hundred Central African refugees are living in this transit center constructed by the government of Chad in order to accommodate the 15,000 people who were evacuated from Bangui, Central African Republic (CAR), by air. Doctors Without Borders/Médecins Sans Frontières (MSF) conducts medical consultations in each of the eight sites hosting the CAR refugees in N’Djamena. MSF’s mobile teams found many patients in need of basic health care, as well as several serious post-op cases that required follow-up. There is an increasing need of water and sanitation provision, which MSF teams are supporting. MSF has also set up operations in the south of Chad, in Bitoye and Sido, where an additional 25,000 refugees have arrived from CAR.

Photo by Samantha Maurin /MSF
The refugees, including many children, from CAR who’ve arrived seeking safety in Sido, Chad, have witnessed the worst atrocities. “Most of the refugees who told me their stories did so in a monotone, with solemn faces,” said an MSF psychiatrist, “without going into details about the bodies carved up in the massacres, keeping their distance from the expression of painful emotions.”http://bit.ly/1mfQyVR

Photo by Samantha Maurin /MSF

The refugees, including many children, from CAR who’ve arrived seeking safety in Sido, Chad, have witnessed the worst atrocities. “Most of the refugees who told me their stories did so in a monotone, with solemn faces,” said an MSF psychiatrist, “without going into details about the bodies carved up in the massacres, keeping their distance from the expression of painful emotions.”http://bit.ly/1mfQyVR

My tukul in Amtiman on my last day © Raghu Venugopal
Amtiman, Chad, now seems so far away from here in Europe. However, if I think of sand on the ground and heat on my skin, potholes in the dirt road, and a few pieces of garbage on the ground between the expat house and MSF office, I am taken back. Thinking of Amtiman is a powerful, spinning feeling. It’s a bit hard to write since I’m so tired right now. All I can mostly do is sleep and walk around in a bit of a daze. But let me try to write something.
Read more: http://blogs.msf.org/raghuv/2013/06/11/berlin-headquarters/

My tukul in Amtiman on my last day © Raghu Venugopal

Amtiman, Chad, now seems so far away from here in Europe. However, if I think of sand on the ground and heat on my skin, potholes in the dirt road, and a few pieces of garbage on the ground between the expat house and MSF office, I am taken back. Thinking of Amtiman is a powerful, spinning feeling. It’s a bit hard to write since I’m so tired right now. All I can mostly do is sleep and walk around in a bit of a daze. But let me try to write something.

Read more: http://blogs.msf.org/raghuv/2013/06/11/berlin-headquarters/

We all knew that late in the dry season, malnutrition would peak. But this week it hit us hard. Our outreach teams had difficulty coping. The hospital was temporarily over-run. Dr. Johanna, our MSF doctor from Sweden, told me the hospital “looked like a refugee camp”. The team and myself surveyed the hospital grounds. Two patients shared a bed in some circumstances; the area we use for children’s play was covered with mattresses on the ground and patients ; and our tent used for epidemic infectious disease was filled with malnourished children … Quickly, we started making plans to deal with the increased numbers.
Doctor Raghu blogs from Chad where MSF teams are working hard to treat rising numbers of children with malnutrition as well as people displaced by conflict. Read about it and leave your comments for Raghu.

Being able to go to the hospital at night requires a proverbial blade, its attachment and a handle. Practically speaking we need drivers, cars, petrol, guards and radio operators to make it happen. We need nurses on duty, who first discover something is wrong. We need logisticians who ensure there are generators to give light to the hospital at night. We need non-medical team members to also order key medications that I or other medics might prescribe at night. We need a coordination team in the capital to reach an agreement with the Ministry of Health that we can work here in Amtiman. And we need donors and supporters who generously give to make all of this possible.

Late at night we need a doctor. But we need a lot more too.

Ali (not his real name) most likely has multidrug-resistant TB (photo with Ali’s permission) © Raghu Venugopal
"Guy presented Ali’s medical history and we all listened. Ali was diagnosed with HIV 11 years ago. He took anti-retroviral  medications, but was not adherent all the time. Ali did not know his CD4 count – a measure of the strength of his immunity. Unfortunately, as well, Ali had been treated for tuberculosis a total of four times – but had never achieved a clinical cure. He had been treated for TB in 2006 for six months, 2007 for eight months, 2010 for eight months and again started TB treatment in October 2012.Guy called me because he suspected Ali had multidrug-resistant TB (MDR-TB). MDR-TB is a major concern of MSF’s since it is under-diagnosed and undertreated around the world. When the diagnosis of MDR-TB is made, the treatment is very difficult.”
Raghu describes how telemedicine, new tests and treatment will hopefully help Ali recover from multidrug-resistant tuberculosis in Chad.     

Ali (not his real name) most likely has multidrug-resistant TB (photo with Ali’s permission) © Raghu Venugopal

"Guy presented Ali’s medical history and we all listened. Ali was diagnosed with HIV 11 years ago. He took anti-retroviral  medications, but was not adherent all the time. Ali did not know his CD4 count – a measure of the strength of his immunity. Unfortunately, as well, Ali had been treated for tuberculosis a total of four times – but had never achieved a clinical cure. He had been treated for TB in 2006 for six months, 2007 for eight months, 2010 for eight months and again started TB treatment in October 2012.
Guy called me because he suspected Ali had multidrug-resistant TB (MDR-TB). MDR-TB is a major concern of MSF’s since it is under-diagnosed and undertreated around the world. When the diagnosis of MDR-TB is made, the treatment is very difficult.”

Raghu describes how telemedicine, new tests and treatment will hopefully help Ali recover from multidrug-resistant tuberculosis in Chad.     

When the plane landed, three of our patients with vesicovaginal fistulas (VVF) emerged. They had been treated in Abeche by the MSF-Switzerland team over the course of many weeks. VVF is a tragic medical problem where there is an abnormal connection between the bladder (or bowel) and vagina. This is often caused by an obstructed labour. Women are divorced, lose their families and are ostracized for this terrible problem. At the MSF-Switzerland “Village des femmes” this problem is surgically repaired and women can recover and gain their strength among other women with the same problem. I am not sure I have seen a more incredibly important and dignity-restoring intervention than MSF’s VVF hospital in Abeche, Chad.
Life changing operations, broken down Landcruisers and the kindness of strangers. Raghu’s break turns into a working holiday, albeit one that he enjoys. Raghu is a medical doctor working with MSF in Chad. Read his blog here: http://msf.me/ZtKwEO
Photo: Refugees displaced by violence in Darfur have settled in Tissi. Chad 2013 © MSF.
Chad: More than 10,000 Refugees Arrive in Tissi Within a Few Days
Roughly 25,000 refugees and returnees had already been living in and around five villages in southeastern Chad for nearly three months. But starting on April 4, 2013, an additional 10,000 began to arrive, having fled violent clashes in Um Dukhun, Sudan, 10 kilometers [about 6 miles] away from the border. And there’s every indication that more are on their way.
They tell similar stories, of villages attacked and set on fire by armed men on horseback, of neighbors and family members killed, of women and children abandoning all their belongings and taking flight. Fighting resumed between several Arab tribes of North and Central Darfur States a few months ago, but the situation has deteriorated dramatically in recent days.

Photo: Refugees displaced by violence in Darfur have settled in Tissi. Chad 2013 © MSF.

Chad: More than 10,000 Refugees Arrive in Tissi Within a Few Days

Roughly 25,000 refugees and returnees had already been living in and around five villages in southeastern Chad for nearly three months. But starting on April 4, 2013, an additional 10,000 began to arrive, having fled violent clashes in Um Dukhun, Sudan, 10 kilometers [about 6 miles] away from the border. And there’s every indication that more are on their way.

They tell similar stories, of villages attacked and set on fire by armed men on horseback, of neighbors and family members killed, of women and children abandoning all their belongings and taking flight. Fighting resumed between several Arab tribes of North and Central Darfur States a few months ago, but the situation has deteriorated dramatically in recent days.

When I sat on the bed across from Hissen, I just looked at him. His serious little face was angry. I fished out my mobile phone and offered it him. He took it carefully with his right hand and held onto it. I kept on giving him more things out of my pockets and he kept taking them only with his right hand. He would not use his left arm at all. After enough temporary gifts, Hissen agreed to shake my hand. Every move I made, he studied me as carefully as I was studying him.

Inspecting his left arm, we could see there was a swelling above his elbow. As gently as I could, I ran my fingers over it. Hissen did not like that. He immediately cried and I had to stop. Something was wrong.

Dr Raghu helps a very scared little boy with sickle cell anemia overcome his fears. Raghu is a Canadian doctor working with MSF in Chad. Please leave your questions and comments for Raghu in the comments box below his blog post. 
As a doctor, in MSF work and in Canada, family members tap me on the shoulder and ask for my attention all the time. It’s hard to know if it is an emergency or a less serious concern. The man who was looking for his brother was just one of these worried family members the night of this critical event. Everyone who has lost their brother or their sister deserves a helping hand. That is what we are here to do.
A traffic accident with around 50 casualties puts Raghu and his team to the test. Raghu is a medical doctor working with MSF in Chad. Please leave your questions and comments for Raghu below his blog post.
"Both babies in breech position were successfully delivered at 3pm in the afternoon in the hospital, and all three are alive today, as well as the mother. Baby one weighed 1900 grams and baby two and three both were 2000 grams. Survival in motherhood is a challenge in this setting and is a key reason for MSF’s work in Chad. Another woman who suffered complications from a spontaneous abortion died last night at our hospital, following a hysterectomy for uncontrollable bleeding."
MSF Doctor, Raghu, blogs about the highs and lows of surviving motherhood in Chad. Please leave your questions and comments for Raghu below his blog post. 

"Both babies in breech position were successfully delivered at 3pm in the afternoon in the hospital, and all three are alive today, as well as the mother. Baby one weighed 1900 grams and baby two and three both were 2000 grams. Survival in motherhood is a challenge in this setting and is a key reason for MSF’s work in Chad. Another woman who suffered complications from a spontaneous abortion died last night at our hospital, following a hysterectomy for uncontrollable bleeding."

MSF Doctor, Raghu, blogs about the highs and lows of surviving motherhood in Chad. Please leave your questions and comments for Raghu below his blog post. 

Photo: Chad 2012 © Florian Lems
MSF Blog: The Clinic Under the Tree
In the shade of a tree, women and children await care at a feeding center run by an MSF mobile unit in Chad. MSF teams make weekly visits to remote communities in Chad to provide much-needed health care to these populations.

Photo: Chad 2012 © Florian Lems

MSF Blog: The Clinic Under the Tree

In the shade of a tree, women and children await care at a feeding center run by an MSF mobile unit in Chad. MSF teams make weekly visits to remote communities in Chad to provide much-needed health care to these populations.

But the work we do – and making it happen – is so much more than physically attending to patients. Direct patient care is the sharp end of the scalpel – but much more makes up the rest of the tool.
Canadian emergency physician Raghu sets off for Chad on his fourth MSF mission where he’s taking on a new challenge as Medical Team Leader. Please leave your comments and questions for Raghu below his blog post.

Malaria: Offering Children a Chance

For the first time, MSF is employing seasonal malaria chemoprevention (SMC) in Chad and Mali. 170,000 children aged between three months and five years received anti-malaria medicines during the peak transmission season. This treatment, recommended by the World Health Organization, will not eradicate malaria definitively. But in countries like Chad and Mali, where malaria is the first cause of infant and child mortality, it does have an important role to play in emergency situations.

There’s always the next emergency; another child who needs help.